Experiences of Christian clients in secular psychotherapy: a mixed-methods investigation

Eleven Christian former clients were sampled to uncover factors contributing to positive versus negative experiences in secular psychotherapy. The qualitative results indicated that although many participants felt hesitant to discuss their faith due to uncertainty about their therapists' reactions, positive experiences were reportedly facilitated by therapists' openness to understanding clients' faith and giving clients control over how much, when, and how to discuss their religious beliefs and practices. Dissatisfied clients reported that their therapists expressed opposing religious views or avoided discussing religious or spiritual issues. Participants' self-reports of the working alliance and of their therapists' expertness, attractiveness, and trustworthiness were largely consistent with the narrative data, but the alliance scores were somewhat more sensitive to participants' positive versus negative evaluations of their therapy experience. That is, several participants rated their therapists' personal characteristics quite favorably but indicated poor agreement with their therapists on the goals or tasks of treatment.     

Qualified therapists’ experience of personal therapy

Recent work shows that the majority of therapists strongly value personal therapy for what it can bring to their professional practice, and for personal development. The aim of this study was to explore qualified therapists’ experiences of personal therapy. Of the 220 qualified therapists who were contacted via post and asked to take part in a questionnaire study, 48 returned the completed questionnaire, which consisted of a series of closed and open questions. Two‐thirds of respondents had engaged in personal therapy. The two most frequently cited reasons for engaging in personal therapy were personal growth and personal distress. Interpretative phenomenological analysis (IPA) identified two broad domains: impact on the person and impact on the professional. Results show that those surveyed recognised the value of personal therapy to themselves as a form of self‐care and personal development. Personal therapy was valued in professional practice as a form of experiential learning from being in the client role. The limitations of this research included a relatively low response rate, raising the question of whether those most likely to have had positive experiences of personal therapy were more likely to participate. Future research might deliberately seek to understand negative experiences of personal therapy. Other avenues for future research include the need to understand how experiences of therapy relate to gender, profession, and therapeutic orientation.     

Feminist Therapy as a Path to Friendship with Women

While many feminist therapists have found that their personal experiences of friendship have given them an experiential base from which to develop their work, some feminist therapists have had alternative journeys through connections with women. This article explores how the author transformed her childhood and adolescent experiences of relational aggression into a deepened understanding of the value and importance of relationships between women. The contributions of misogyny and sexism to relational aggression among girls and women, and their enduring effects on all women's relationships to other women is explored. Finally, the author describes her intimate e-epistolary friendship with two other women, and considers how the medium of email and other forms of electronic communication may facilitate emotional intimacy for women who have experienced relational aggression with other women.     

Understanding autism: how family therapists can support parents of children with autism spectrum disorders

The number of children diagnosed with an Autism Spectrum Disorder has increased dramatically in the last 20 years. Parents of children with autism experience a variety of chronic and acute stressors that can erode marital satisfaction and family functioning. Family therapists are well-suited to help parents stay connected to each other as they create a "new normal." However, family therapists need updated information about autism, and they need to understand how family therapy can help parents of children with autism. Because having a child with autism affects multiple domains of family life, this paper explores how family therapists can utilize an integrative approach with parents, enabling them to flexibly work with the domains of action, meaning, and emotion.     

"It's led me astray": How Cognitive Behavioural Therapists experience personal therapy in clinical practice

Personal therapy is considered to be an essential component of most psychotherapeutic training programmes. However, it remains peripheral to cognitive behavioural therapy (CBT) training courses. We present a subsection of results from a qualitative study that examines how CBT therapists use personal therapy in their clinical practice. Seven CBT therapists who have undergone personal therapy were interviewed. Participants were asked about how they used personal therapy in their clinical practice and their accounts were analysed using interpretative phenomenological analysis (IPA) to identify common themes. This article presents the results of the first master theme, “Personal therapy creates conflict”, which explores a paradox that arises between personal therapy and CBT clinical practice; participants suggest that personal therapy equips them with therapeutic tools that paradoxically hinder their capacity to practice a standardised protocol‐led CBT. Results show that participants found personal therapy created considerable internal conflict, where their use of technical evidence‐based treatment protocols as practitioners was experienced in tension with the relationally oriented therapy they had received as clients. We discuss results in the context of Gabriel Marcel's philosophical insights on the dehumanising effects of technology on human relationships. We conclude with a brief consideration of the current political climate that increasingly privileges short‐term technical solutions to psychological distress.     

How beginning counselors learn: The interaction of personal and professional experiences in counselors with an experiential orientation

Research suggests that the way counselors work is influenced not only by training and practice but also by their personal experiences and qualities. In this study, we aimed to explore how beginning counselors with an experiential orientation integrate the experiences from different sources (e.g. training, supervision, individual therapy, practice, and their personal life) and how they utilize them in practice. Seven in-depth interviews with beginning Gestalt-oriented counselors were conducted and grounded theory method was used for analysis. The results show that personal experiences and qualities play an important role in shaping the way beginning Gestalt counselors work. We conceptualized two main components of counselors’ working style – Personal Core and Professional Extension, and 10 specific types of interaction between these components which were subsumed into two broad categories: (1) cultivation of personal qualities and (2) adoption of new competencies. These findings challenge earlier assumptions that beginning counselors simply imitate their trainers, supervisors, and senior colleagues. Implications for further research and use in practice are discussed.     

Family Secrecy in Family Therapy Practice: An Explorative Focus Group Study

The aim of this focus group study was to explore the experiences of family therapists working with family secrecy. Our study highlights that family secrets present important and compelling challenges for family therapists. Furthermore, our study reveals that there seem to be some basic strategies family therapists use in dealing with these challenges in therapy sessions. One basic strategy is that family therapists try to guard their position of being a trustworthy therapist for each family member by avoiding becoming stuck in family secrecy. Furthermore, therapists explore ways to guide the family toward the disclosure of the secret in order to alleviate the toxicity of the secrecy. This highlights the importance of the systemic model and how influential this perspective is in family therapy practice. Some participants, however, have in addition a second strategy they sometimes use: talking with the family about secrecy without aiming to disclose the secret. In the discussion section of the article we reflect on the possibility that in the strategic choices family therapists make conceptual issues might be involved. Furthermore, we stress the importance of further research.     

Therapist perspectives on working with fears,blocks and resistances to compassion in compassion focused therapy

Objective

A core aspect of compassion focused therapy (CFT) is addressing fears, blocks, and resistances (FBRs) to compassion. How CFT therapists do this with clients remains unclear. This study aims to explore the perspectives of well-trained, experienced CFT therapists regarding how they work with FBRs in the context of CFT.

Methods

A qualitative study was conducted. Participants were asked five open-ended questions regarding (a) their experiences of working with FBRs to compassion, (b) how they understand and formulate FBRs, (c) specific ways they address FBRs, (d) how other therapists might learn about working with FBRs, and (e) their top recommendations. A total of 64 participants completed the online questionnaire, and the qualitative data were analysed using thematic analysis.

Results

The analysis produced four interrelated superordinate themes: (a) Getting “alongside” and “behind”: The central role of formulation, (b) “It's not your fault”: Psychoeducation, (c) “Get experiential”: An emphasis on experiential interventions, and (d) “Respect the wisdom”: The importance of therapeutic process.

Conclusions

Working with FBRs to compassion is critical in CFT. Understanding the wisdom in the client's FBRs, and validating and de-shaming the client's FBRs are crucial. We provide clinical recommendations regarding working with FBRs as part of CFT.     

Person‐centred counsellors' experiences of working with clients in crisis: A qualitative interview study

Aims: This study aims to explore and understand person‐centred therapists’ experiences and work with clients at the pivotal point of crisis. Specifically: how do person‐centred therapists experience working with clients in crisis? Do they identify differences in crisis intervention compared to non‐crisis work? What do they perceive as helpful to crisis clients? How relevant are therapists' own experiences of crisis? Method: Participants were all experienced person‐centred therapists. Qualitative, semi‐structured interviews were conducted and the data were analysed qualitatively using person‐centred/phenomenological methodology. Results: Respondents identified differences in their experiences. Typically, therapists described polarity in their experience of danger and opportunity, also heightened energy levels within themselves, perceived higher levels of engagement, faster pace of work, experiences of reaching ‘relational depth’ earlier, and the importance of assisting symbolisation of clients' experience in awareness. Clients were experienced as vulnerable, unable to access previous coping mechanisms, in a state of breakdown and disintegration, but also as wide open, having dropped their usual defences, and more available to engage in therapy and enter the process of change and potential post‐crisis growth. Discussion: The findings are discussed in relation to prevailing models of crisis intervention, person‐centred theory and theoretical developments in post‐traumatic growth in the aftermath of crisis.     

Theory of Change Projects in MFT Programs

Taibbi (1996) suggests that therapists who have clear ideas of their personal models of therapy will be better therapists. This study attempted to learn more about how marriage and family therapy (MFT) programs use theory of change projects to assist students' development of their personal models. Questionnaires were sent to MFT master's, doctoral, and post-degree programs accredited by the Commission on Accreditation for Marriage and Family Therapy. Nearly 60% of responding programs indicated that they do include theory of change projects in their programs. Data were analyzed for similarities and differences in both the contents and processes of the projects.     

Using a Narrative Metaphor: Implications for Theory and Clinical Practice

The evolution of family therapy from a cybernetic metaphor to a narrative metaphor has led us to think differently about therapy, about clients, and about ourselves as therapists. In this article we pursue how this different way of thinking has informed a theoretical understanding of a narrative therapy approach and consequently has opened space for different ways of working clinically. We begin by tracing the evolution to narrative; we consider the implications of social constructionism and its political effects; and we complete the discussion by focusing on narrative theory. We then show how the clinical work follows logically and is coherent with the theoretical considerations. We describe, and illustrate with clinical examples, an innovative approach to working with couples and families with adolescents. In this work we pay attention to the larger cultural stories, including gender constructions, and to personal stories that persons have created to make meaning out of their experience as they interact with one another in a reciprocal meaning-making process. Interventions focus on externalizing the problem narrative that is influencing the client(s), mapping the effects of the problem pattern and/or the totalizing view persons might have of others, and creating space for client(s) to notice preferred actions and intentions. Finally, we close the loop by asking questions of ourselves and others about the effects of working from a narrative metaphor.     

Movies on the couch: The MOVIE model of film therapy

Film therapy, the therapeutic use of movies in psychological therapies, is a growing area of interest to therapists and researchers. This paper discusses the benefits of film therapy and presents a method, the MOVIE model of film therapy, a widely applicable, trauma-informed framework for individual or group therapy, counsellor education and self-help. Film or cinema therapy is a highly accessible and relatable method for many diverse groups. The benefits identified include emotional processing, greater ease of dialogue, increased empathy, interpersonal learning, new perspectives and learning skills. Following the model's reflective steps, clients mindfully observe and voice their emotional and psychological responses to movie-watching; identify how the imagery, characters, themes and story symbolise personal experience; and consider any new possibilities that emerged for their own lives. The model is informed by a practice-focussed review of literature and draws on methods from mindfulness and experiential and narrative therapies. The steps are widely applicable in a range of settings and can be adapted across counselling modalities. Further research to consider the outcomes of using the model, alongside qualitative research on clients' experiences of working this way with film, is recommended.     

Practising family therapy in India: how many people are there in a marital subsystem?

Systemic therapy would appear to be a viable form of treatment for people who exist in cultures that contain complex, extended family systems, such as those found in India. The practice of family therapy in India has evolved from Western concepts. These concepts appear to offer Indian therapists relevant and practical ways of working with families. However, some of these concepts need modifying before they can be used in an Indian context. Indian families may have very different worldviews and ideas of 'self' compared to families in the West, leading to different family organization. The situation can be further complicated by the cultural norms of therapists themselves. Therapists in India are often highly educated, come from upper-middle-class families and have been exposed to different cultures. They increasingly share many of the values of their counterparts in the West. At the same time, they retain aspects of their own cultural heritage, which is also the dominant culture for a large number of the families with whom they work. Thus, not only must Indian family therapists seek to work in culturally appropriate ways; they must also tolerate their own internalized conflicts regarding differing cultural norms. With the use of clinical data, this paper describes some of the personal and professional problems experienced by an Indian family therapist working with Western constructs of family organization.     

Self-of-the-Therapist Work: A Balance Between Removing Restraints and Identifying Resources

The authors propose that self-of-the-therapist work is most productive when therapists and supervisors approach family of origin issues and historical life events in a balanced way and suggest that they move to an approach that ideally liberates restraints posed by self-of-the-therapist issues, while at the same time accesses resources available to therapists because of the same issues. This is a shift from the primarily restraint focus that has dominated self-of-the-therapist work. This paper also provides personal experiences of the authors, guidelines on how to create safety and balance, as well as practical examples of self-of-the-therapist exercises.     

How trainees develop an initial theory of practice: A process model of tentative identifications

Aim: The increasing importance of integrative practice highlights the need to explore how trainees develop their theoretical stance. This investigation explored the experiences of trainees to elaborate a model of how they developed their personal theories of practice. Method: Seventeen Masters level trainee counsellors kept weekly journals recording how they developed a working theory of practice. Grounded theory analysis of the journals was used to develop a model of the process. Findings: The resulting Process Model of Tentative Identifications illustrates how a personal theory developed through trainees' tentative identifications with theories of practice, and how factors such as reading, personal philosophy, practice, and supervision interact to produce the identifications. A diagram of the model highlights the relationships among a variety of personal and professional factors that ranged from highly abstract to concrete and practice-based. Discussion: The model is consistent with several factors identified in previous research and highlights how trainees develop working theories of practice.     

Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach.     

Unheard Voices: The Experiences of Supervisors in Training

This paper seeks to expand on the supervision literature by exploring the experiences of five supervisors in training (SIT) as they navigate the transition from therapist to supervisor. Five key elements of the process of becoming a supervisor are highlighted; contracting, ethics, diversity, modalities, and troubleshooting. Each element is described in two parts: (1) information provided by current supervision literature and (2) by personal journal entries of SITs in an approved supervision course during their doctoral studies. The journal entries of the SITs describe the journey in forming their own supervision identity which included understanding how to include the five key elements in their own supervision with their supervisees. A postmodern approach was utilized to understand this process as well as shape the paper. The goal of this paper is to understand the experiences of supervisors who will shape the development of future therapists.     

“Why would you want to do that work?” The positive impact on therapists of working with child victims of sexual abuse in Ireland: a thematic analysis

Abstract

Research on the impact on psychotherapists of working with trauma has typically focused on negative impact and protective strategies and supports for therapists working in this field, such as self-care strategies and supervision. Yet many clinicians speak of the rewarding and fulfilling experiences of working with those who have been sexually abused. This study explored the positive impact of working with children who have been sexually abused in a sample of psychotherapists in Ireland. Unstructured interviews were conducted with nine female therapists who work in a specialist sexual abuse service with child victims of sexual abuse. An inductive thematic analysis identified four key themes: “the struggle to talk about the positive impact”, “professional satisfaction from helping children”, “learning life lessons from children” and “the magical connection that happens in therapy”. The findings show that, despite therapists’ tendency to think about negative impact, when encouraged to do so they described finding the work professionally rewarding, experiencing an enhancement of their own attitudes and lives through learning from the children they worked with and feeling uplifted within the therapeutic relationship with the child. Suggestions are offered for future research that may provide a broader understanding of the positive impact of this work.     

Critical incidents: Life events for experienced family therapists

Summary The results of this investigation suggest that therapists' professional style and clinical use of self patterns are impacted by critical life events occurring in their personal life. Many subjects reflected on how changes in their family constellations (both family of origin and family of procreation) were important to their professional development. They frequently mentioned that marriage, children, divorce, and illness or death of a loved one impacted their personal and, then, their professional lives. The important life events of becoming a parent or losing a significant loved one was specifically mentioned as strongly influencing changes in one's professional direction and therapeutic style.Becoming a parent caused the interviewees to reevaluate their expectations of their own parents, their client families and themselves. Changes in career aspirations, interactional patterns, and the capacity to be consistent and calm were explored and understood differently. Many subjects described how this transition in their own life shifted their primary focus and altered many of their existing relationships. In particular, female therapists with younger children related how their sense of being female changed. They sought out other women for intimate contact more frequently, they understood their own mothers better, and they frequently were less judgmental of mothers in their client families.Along with creating their own families, death of a parent was keynoted as having a strong impact on the subjects' personal and professional lives. They described questioning (and frequently changing) the amount of time they spent working and the type of work they did. Many began to push for more emotionally intense relationships personally and therapeutically. Detailing how their therapeutic goals for a family now included connection-making rather than just problem solving, they described being much more willing to share their vulnerabilities and personal needs with clients.